Abstract
PurposeNon-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC.MethodsWe collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan–Meier method.ResultsWe identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi’s sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI95 2.15–16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies.ConclusionNon-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival.
Highlights
More than 95% of all malignant laryngeal neoplasms are represented by squamous cell carcinoma (SCC) [1]
The usual submucosal growth pattern and supraglottic or subglottic location frequently cause a delay in diagnosis, which might happen at an intermediate-advanced local stage [3]
We retrospectively evaluated data on 592 patients affected by laryngeal neoplasms treated at two Italian institutions, between 2012 and 2017
Summary
More than 95% of all malignant laryngeal neoplasms are represented by squamous cell carcinoma (SCC) [1]. About 5% of the remaining are composed of other histotypes originating from minor salivary glands, bone, cartilage, muscle, fatty tissue, neuronal, and connective tissue. These are cell types seen throughout the aerodigestive tract. European Archives of Oto-Rhino-Laryngology and, within the larynx. The entire group of these tumors is considered as rare non-SCC tumors [2]. Due to the paucity of cases, outcomes associated with non-SCC laryngeal cancers are not well characterized
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